Provider Demographics
NPI:1326195595
Name:HAMILTON, QUYEN THUY DI (OD)
Entity Type:Individual
Prefix:DR
First Name:QUYEN
Middle Name:THUY DI
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 VILLAGE PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3244
Mailing Address - Country:US
Mailing Address - Phone:972-317-0831
Mailing Address - Fax:972-317-1360
Practice Address - Street 1:1601 VILLAGE PKWY STE 160
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-3244
Practice Address - Country:US
Practice Address - Phone:972-317-0831
Practice Address - Fax:972-317-1360
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6501TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81510QOtherBLUE CROSS BLUE SHIELD